‘There’s no salary’: DRC health workers tell of hardship as Ebola spreads

Bunia, Democratic Republic of the Congo: The warning from the World Health Organization (WHO) is dire: The current outbreak of the Ebola virus currently spreading in the eastern Democratic Republic of the Congo (DRC) might be one of the world’s worst, the agency has said over and over.

In the worst outbreak on record, the haemorrhagic viral disease killed more than 11,000 people in West Africa between 2014 and 2016. In the second-largest outbreak, from 2018 to 2020, 2,287 deaths were recorded in eastern DRC.

Recommended Stories

• list 1 of 4WHO warns DR Congo Ebola outbreak may be double the official tally
• list 2 of 4DRC Ebola cases surpass 2,000 as more health workers begin strike
• list 3 of 4WHO: Ebola spreading faster than ever recorded in DR Congo
• list 4 of 4Ebola spreading more quickly in DRC, while Uganda discharges last patient

Health authorities warn this outbreak could be even more widespread because the region is battling the rare Bundibugyo strain, which has no approved treatments or vaccine. Second, the disease had been transmitting for weeks without official detection before an outbreak was officially declared on May 15. Analysts point to severely weakened disease surveillance resulting from global health aid cuts in the past year.

The virus is also spreading in eastern DRC, a region that is seeing protracted conflict, and where distrust of authorities is high, making it hard to track suspected or confirmed cases. The epicentre is Ituri province, near the Ugandan border.

By July 21, more than 2,500 cases and 1000 deaths had been recorded, according to WHO. Uganda reported 20 cases, and two deaths. By July 16, authorities said the last confirmed patient had recovered.

By comparison, during the 2018 outbreak in the DRC, it took more than 10 months for the number of cases to reach 2,000.

At the forefront of the fight to break the spread are health workers dealing with the risk of getting infected, a shortage of personal protective equipment (PPE), and deadly attacks from suspicious communities who do not believe in the virus, and thus do not seek medical help.

Many health workers also complain about unpaid salaries. Last week, dozens at the Rwampara General Hospital downed their tools in a strike. The hospital operates a major Ebola treatment centre and is located close to the city of Bunia in Ituri. In May, parts of the centre were burned down by angry residents who also chased after health workers fleeing in trucks.

More than 100 health workers have been infected, and about 35 have died.

Two health workers spoke to Al Jazeera about the unique challenges they face. Here are their stories:

Fearing Ebola infection and angry mobs

Health worker Paluku Audrey stands at a market in Bunia, Ituri Province. The 29-year-old must enter communities to explain to distrusting residents about the risks of Ebola infection [Prosper Heri Ngorora/Al Jazeera]

My name is Paluku Audrey. I am 29 years old, and I work as a community engagement officer at the local hospital centre in Rwampara. My work is to go into different communities and tell people about the risk of Ebola disease. It means I have to meet people every day even though many of them don’t believe this disease exists. Sometimes, people are physically hostile.

I have been involved since May, when the outbreak was declared. My colleagues and I were quickly mobilised for this situation. I told myself that I have to come to work urgently – not to make money, but first and foremost to save people’s lives.

I wake up every morning at 6am. I get ready and leave the Kindia neighbourhood of Bunia where I live to head to work. My home is more than 10 kilometres (6.2 miles) from the Rwampara health centre. Sometimes I take a bus, but other times, I have to walk the whole way, even though it’s a long journey. I don’t have enough for transport as our salaries have not been paid since we started in May. I am not even sure of the exact pay.

The biggest problem we face is scepticism on the part of communities who don’t understand the risk posed by the Ebola virus disease. Some people can’t even believe it exists. There are also many conspiracy theories surrounding this disease. Some say it is a punishment from the ancestors. Others say it is a disease manufactured to reduce the earth’s population.

Every day, my colleagues and I have to walk through streets and hostile neighbourhoods in Bunia, where people look at us with distrust and think we are lying about Ebola. We do this from morning until evening.

We tell people about hygiene measures to prevent Ebola, and what it looks like when someone is infected. We tell them how important it is to go to the hospital once they feel unwell.

Some people accept, but the majority refuse to accept these messages. Sometimes, they throw stones at us. Crowds are unforgiving when they are angry.

My greatest fears are catching Ebola one day, or being attacked by a mob.

I was close to being attacked once. I was out working as usual that day when I was suddenly attacked and detained by some young people. They accused me of exaggerating the disease to make money for myself. Fortunately for me, I had contacts in the area who came to rescue me and stopped them from stoning me.

I try to keep myself safe against Ebola by carrying a bottle of disinfectant and a mask with me wherever I go. Sometimes I wear gloves. But as for keeping myself safe from hostile people, I try to show some empathy. If there is danger, though, I run.

I come from a poor family, and I’m the only one who has a job. I often struggle to pay my bills. I think of my family members who rely on me. They tell me they fear for my life. I personally think life is about risks and opportunities, but sometimes, I wonder how they’ll manage if I’m no longer here.

A day I cannot forget was when I helped to transport the very first bodies of people who were suspected of dying from Ebola, at the start of the outbreak. People in that neighbourhood were so angry. They tried to force us to open the coffin to make sure there was really a dead person in there. My colleagues and I refused, but they threatened to beat us. It was tense.

I feel that it’s a shame that we have been working for many weeks without even being able to buy a single litre of water. The international donors funding the response to this epidemic should do their utmost to exert pressure on the government to ensure we are paid.

Despite some resistance, my awareness-raising efforts are working. I know because many people have promised me they will do as I advise, and also pass on my messages to others. It makes me proud that my work saves lives. I believe my country will one day be grateful to me.

‘The outbreak took his life’

My name is Ghislain Maneba. I am 35 years old, and I am an epidemiologist in the Rwampara treatment centre.

My work is to go into people’s homes and help transport suspected cases of Ebola to the treatment centre for tests. Those who are ill, we help to treat them with dedication.

Maneba, an epidemiologist working on the DRC response team, stands outside the Rwampara General Hospital in Ituri. He is one of several who have not been paid since the outbreak began [Prosper Heri Ngorora/Al Jazeera]

My family is worried, but they have been nothing but supportive. As the breadwinner for my little family, they rely on me to survive.

Ebola isn’t like malaria or typhoid fever. It strikes very hard, and that scares me. Some doctors have fallen ill. I often think that tomorrow, it could be me, even though I don’t want it to be.

When I wake up every morning and every evening before I go to sleep, I think of the oath I’ve sworn to save lives. I feel very tense about the long day ahead of me: diagnosing people, going out into the community to deal with the unusual rise of cases there. When I see the case numbers, I wonder exactly whether we should fear the future.”

But, like any other worker, I get ready in the morning and take a motorbike taxi to get to work on time. We’ve been given some protective equipment, such as boots, gloves and so on, although they are not sufficient for us.

We’re also disinfected every time we come into contact with a confirmed or suspected case.

The biggest challenge at the moment is the lack of wages and bonuses. Sometimes we struggle to pay for transport to and from work. It’s a shame that we haven’t been paid so far.

People have fixed ideas about this epidemic. People always say that Ebola is imaginary. And many people say this because they’ve heard others say it too.

But we’re not giving up. We’re carrying on with our work.

My worst memory from this outbreak is attending the funeral of a fellow doctor who died of Ebola. He was so brave and full of ambition. Sadly, this outbreak took his life. When I think about it, my heart breaks. But it also motivates me to honour him by working tirelessly.

What people don’t realise about my job is that it’s very demanding and requires self-sacrifice. I have sacrificed my time, time that should be for my loved ones.

Still, the most important thing for me is that I’m writing a page of history with this response. My experience is being put to good use in the fight against Ebola, and that’s something that makes me proud.

I would be happy if the world takes this disease seriously and if substantial resources are deployed to combat it. If we are paid according to how big our tasks are, things will be better for me. Also, if work vehicles and food are deployed for us as has been announced in the media, that would be better too.